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General NPI Number Information
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NPI Number | 1831912781
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Entity Type | Individual
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Provider Name | ALICEA LIVI BAXTER
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 8354 E NORTHFIELD BLVD UNIT 3700
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City | DENVER
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State | CO
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Zip | 80238-3135
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Country | US
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Telephone | 480-757-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 4662 E BEVERLY LN
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City | PHOENIX
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State | AZ
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Zip | 85032-3409
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Country | US
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Telephone | 617-686-4869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-325013
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License Number State | AZ
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